Possibilities of microneedling in the combined therapy of vitiligo. Literature review

Abstract

The Vitiligo therapy is still a topical issue today. According to the Russian and European clinical guidelines, modern therapy for vitiligo includes UVB-311 nm phototherapy, topical glucocorticoids and topical calcineurin inhibitors. Standard treatment regimens require a long time of application and their effectiveness on the average does not exceed 40%, which leads to disappointment in the treatment not only for patients but also for dermatologists. In this regard an active search for therapies for vitiligo continues. Thus, one of the modern options for the treatment of this disease is microneedling.
 Microneedling is a relatively new, easy to perform, safe and minimally invasive therapeutic technique that enhances the regenerative process by creating numerous microtraumas occurring when shallow needles are punctured into the skin. This procedure causes a cascade of reactions similar to the wound healing process, stimulating the production of collagen, elastin and growth factors and increases the migration of melanocytes and keratinocytes leading to repigmentation of vitiligo lesions. Local damage to the skin with needles enhances penetration of active ingredients into deeper layers, so microneedling is often combined with the use of UV light, as well as with various biopharmaceuticals to increase efficiency. Although the procedure is relatively new it has demonstrated efficacy, good tolerability, limited undesirable effects and a short recovery time, making micro-needling a promising treatment for vitiligo.
 This article is a review in nature. The purpose of this review is to update the available information on the treatment of vitiligo as well as to explore a promising new method of therapy. A systematic literature review was conducted using PubMed, Cochrane Library, CyberLeninka, Clinicaltrial.govand the open-access Internet databases to examine the efficacy, principles of action, and tolerability of the new treatment. Key words used in the literature search in the aforementioned databases were vitiligo, vitiligo treatment, microneedling, and quality of life .The results of various clinical studies are presented.
 This review is addressed to practicing dermatovenerologists interested in vitiligo therapy.